US · guidance
CMS Pub. 100-05, ch. 5, § 60.1.3.5
Exhibit 2: CWF Source Codes and Corresponding CROWD
Special Project Numbers
(Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22)
CWF Source
Codes
MSP/COB
Contractor
Numbers
Nonpayment/
Payment
Denial
Codes
CROWD Special
Project Numbers
B, D, T, U, V, or
W
77777 =
IRS/SSA/HCFA Data
Match (I, II, III, IV,
V, or VI)
Y 1000
O 99999 = Initial
Enrollment
Questionnaire (IEQ)
T 2000
P 55555 = HMO Rate
Cell Adjustment
U 3000
33333 = Litigation
Settlement
V 4000
Q 88888 = Voluntary
Agreements
Q 5000
0 11100 = COB
Contractor
00 6000
1 11101 = Initial
Enrollment
Questionnaire (IEQ)
T 6010
2 11102 =
IRS/SSA/CMS Data
Match
Y 6020
3 11103 = HMO Rate
Cell
U 6030
4 11104 = Litigation
Settlement
V 6040
5 11105 = Employer
Voluntary
Reporting
Q 6050
6 11106 = Insurer
Voluntary Reporting
K 6060
7 11107 = First Claim
Development
E 6070
8 11108 = Trauma
Code Development
F 6080
9 11109 = Secondary
Claims
Investigation
G 6090
CWF Source
Codes
MSP/COB
Contractor
Numbers
Nonpayment/
Payment
Denial
Codes
CROWD Special
Project Numbers
10 11110 = Self Reports H 7000
11 11111 = 411.25 J 7010
12 11112 = Blue Cross
– Blue Shield
Voluntary
Agreements
12 7012
13 11113 = Office of
Personnel
Management
(OPM) Data Match
13 7013
14 11114 = State
Workers’
Compensation (WC)
Data Match
14 7014
15 11115 = WC Insurer
Voluntary Data
Sharing Agreements
(WC VDSA)
15 7015
16 11116 = Liability
Insurer Voluntary
Data Sharing
Agreements
(LIAB VDSA)
16 7016
17 11117 = Voluntary
Data Sharing
Agreements (No Fault
VDSA)
17 7017
18 11118 = Pharmacy
Benefit Manager Data
18 7018
19 11119 = Workers’
Compensation
Medicare Set-Aside
Arrangement
19 7019
20 11120 = To be
determined
20 7020
21 11121 = MIR Group
Health Plan
21 7021
22 11122 = MIR non-Group Health Plan
22 7022
“” “” “” “”
CWF Source
Codes
MSP/COB
Contractor
Numbers
Nonpayment/
Payment
Denial
Codes
CROWD Special
Project Numbers
25 11125=Recovery
Audit Contractor-California
25 7025
26 11126=Recovery
Audit Contractor-Florida
26 7026
27 11127=To be
Determined
27 7027
39 11139 = Group
Health Plan Recovery
39 7039
41 11141 = Non-Group
Health Plan Non-
ORM Recovery
41 7041
42 11142 = Non-Group
Health Plan ORM
Recovery
42 7042
43 11143 = MSP
Contractor/Medicare
Part C/Medicare
Advantage
43 7043
44 11144 = Liability
Medicare Set Aside
Arrangement
44 7044
45 11145 = No-Fault
Medicare Set Aside
Arrangement
45 7045
99 11199 = To be
determined
99 7099
History
(Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
eb4ea9d06cc4ba1044793250ae8b00ca8a982dbfe19fb4bbc6401d7fa5808828
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